摘要
Abstract
OBJECTIVE To evaluate the cost-effectiveness of apatinib combined with adriamycin in the second-line chemotherapy of platinum-resistant recurrent ovarian cancer(OC)from the perspective of the health system in China.METHODS A three-state partitioned survival model was constructed based on the APPROVE clinical trial and related literature data,with a model simulation time frame of 10 years and a 4-week cycle,and both cost and utility values were discounted using a 5%discount rate.Cost and quality-adjusted life years(QALYs)were used as a model output indicator and the incremental cost-effectiveness ratio(ICER)was calculated to evaluate the cost-effectiveness of apatinib combined with adriamycin versus adriamycin chemotherapy in the second-line treatment of platinum-resistant recurrent OC.One-way sensitivity analysis,probability sensitivity analysis and scenario analysis were used to verify the robustness of the base-case analysis results.RESULTS The results of base-case analysis indicated that compared with chemotherapy alone,ICER of patients receiving apatinib combined with adriamycin was 124678.25 yuan/QALY,which was less than willingness-to-pay(WTP)threshold set in this study[3 times per capita gross domestic product(GDP)of China in 2022(257094 yuan)].The results of scenario analysis showed that,with the extension of the simulation time limit,the ICER of apatinib combined with adriamycin was gradually reduced,and the decline was gradually reduced,but both were less than WTP threshold.The results of single factor sensitivity analysis showed that the factors that had the greatest impact on ICER were the utility value of progression,body surface area,discount rate,and the cost of best supportive treatment,etc.The results of probability sensitivity analysis showed that under WTP threshold set in this study,the economic probability of apatinib combined with adriamycin was about 99%.CONCLUSIONS From the perspective of China's health system,using three times the per capita GDP in 2022 as the WTP threshold,the combination of apatinib and adriamycin is more cost-effective than adriamycin alone in second-line chemotherapy for platinum-resistant recurrent OC.关键词
阿帕替尼/多柔比星/铂类耐药/复发性卵巢癌/分区生存模型/成本-效果分析Key words
apatinib/adriamycin/platinum-resistant/recurrent ovarian cancer/partitioned survival model/cost-effectiveness analysis分类
药学
